By Erin Blakemore
August 19, 2023 at 6:00 a.m. EDT
Children and adolescents who have been physically assaulted are nearly twice as likely as their peers to develop mental illness after the assault — and the risk is even higher in the first year after an incident, research suggests.
The analysis, published in JAMA Network Open on Wednesday, looked at the medical records of 27,435 children in Ontario, Canada, including 5,487 kids who had been at an emergency room or hospital after a physical assault between 2006 and 2014 before age 14.
While 38.6 percent of kids who had been assaulted received mental health diagnoses after the assault, just 23.4 percent of those who hadn’t experienced assault had a mental health diagnosis. Kids who had been assaulted were 1.96 times as likely to be diagnosed with mental illness, especially in the year following an assault, when they were 3.08 times as likely to receive a mental health diagnosis.
The children who had been assaulted were likelier to be diagnosed with nonpsychotic disorders, behavior disorders such as attention-deficit/hyperactivity disorder, substance use disorders and intentional self-injury. Most were diagnosed in an outpatient setting, but 14 percent received the diagnosis in an ER or a hospital, compared with 2.8 percent of children who were not assaulted, and 2.4 percent received the diagnosis after intentional self-harm, compared with 0.5 percent of the children who were not assaulted.
Kids who survived assaults were likelier to have mothers with mental illness (34.5 percent compared with 19.1 percent of those who hadn’t been assaulted) and to have mothers who reported domestic violence or assault (4.6 percent vs. 0.5 percent for children who hadn’t been assaulted). They were also far likelier to have a mother who was younger than 19 when she gave birth.
The researchers acknowledge that the number of children in the cohort who actually had been physically assaulted was probably higher than reported, because many assaults don’t result in ER visits or hospitalizations.
The study also excluded children who were diagnosed with a mental illness before a known assault. “It is also possible that children who experienced assault more frequently encounter the health system due to their injury and have greater opportunity for mental illness detection,” they write.
It’s important to treat children in the year after a known assault, the study suggests, adding that interventions should be tailored to the most prevalent types of assault-linked mental illnesses.
“Physical assault during childhood is common and can lead to lasting mental health problems,” the researchers write. The Centers for Disease Control and Prevention estimates that 1 billion children — half of all the children in the world — are victims of violence each year.